Acceptance of cravings: how smoking cessation experiences affect craving beliefs.

Metacognitive models theorize that more negative appraisals of craving-related thoughts and feelings, and greater efforts to avoid or control these experiences, exacerbate suffering and increase chances the person will use substances to obtain relief. Thus far, little research has examined how attempts to quit smoking influence the way people perceive and respond to cravings. As part of a larger study, 176 adult smokers interested in quitting participated in two lab sessions, four days apart. Half the sample began a quit attempt the day after the first session; craving-related beliefs, metacognitive strategies, and negative affect were assessed at the second session. Participants who failed to abstain from smoking more strongly endorsed appraisals of craving-related thoughts as negative and personally relevant. Negative appraisals correlated strongly with distress and withdrawal symptoms. Attempting to quit smoking increased use of distraction, thought suppression and re-appraisal techniques, with no difference between successful and unsuccessful quitters. Negative beliefs about cravings and rumination predicted less change in smoking one month later. Results suggest that smoking cessation outcomes and metacognitive beliefs likely have a bidirectional relationship that is strongly related to negative affect. Greater consideration of the impact of cessation experiences on mood and craving beliefs is warranted.